Abstract Details

Title Real-World Effectiveness of Eptinezumab after Treatment with Subcutaneous CGRP Monoclonal Antibodies in Patients with Migraine

Topic Headache

Presentation(s) P12 - Poster Session 12 (5:30 PM-6:30 PM)

Poster/Presentation
Number 2-009

Objective

To evaluate the effectiveness of eptinezumab in patients with migraine after 6 and 12 months.

Background Patients who switched from subcutaneous CGRP mAbs to intravenous CGRP mAb (i.e., eptinezumab) are refractory to most preventive medications. While several real-world studies reported positive outcomes within 6 months of eptinezumab use, the eptinezumab usage pattern and treatment response after 1-year remain unknown.

Design/Methods

This single-center retrospective study examined the first 30 subjects who received eptinezumab at the Jefferson Headache Center. We collected demographics, reasons for the switch, and usage pattern/response to eptinezumab after 6 and 12 months. The generalized estimating equation (GEE) test adjusted for age, sex, and BMI was used for repeated measure analysis. Missing data were not included.

Results

We reviewed 30 patients (25 female, age 52.3±12.6, BMI 28.3±6.1) who experienced headaches for 26.8±17.8 years and switched to eptinezumab. At the index date, all subjects received a 100mg regimen and reported a mean monthly headache (MHD) of 24.6±8.6 and average pain intensity (API) of 6.2±1.8. After 6 months, 23 subjects continued, and 14 (61%) received a 300mg regimen. They had an MHD of 24.5±9.4 (n=16) and API of 5.7±1.4 (n=14). After 12 months, 15 subjects continued, and 10 (71.4%) were on a 300mg regimen. These subjects had an MHD of 22.5±10.5 (n=12) and API of 5.5±1.3 (n=12). The main reasons for eptinezumab discontinuation were inadequate response (n=6/15; 40%), intolerance (n=3/15; 20%), and insurance (n=5/15, 33%). There were insignificant reductions at 6 and 12 months of MHD (-0.71, 95%CI -3.42 to 2.00, p=0.61; -1.36, 95%CI -4.52 to 1.81, p=0.40) and API (-0.46, 95%CI -1.17 to 0.24, p=0.20; -0.63, 95%CI -1.38 to 0.13, p=0.11).

Conclusions

In our study, patients may sustain no apparent benefit upon switching to eptinezumab after 6 or 12 months, reflecting the refractory nature of this study population. More prospective studies are needed.

Authors/Disclosures
Emily Casaletto PRESENTER	Miss Casaletto has nothing to disclose.
Qiu Zi Yang, MD	Dr. Yang has nothing to disclose.
John Waters	Mr. Waters has nothing to disclose.
John Curran	Mr. Curran has nothing to disclose.
	No disclosure on file
Hsiangkuo Yuan, MD, PhD (Jefferson Headache Center)	An immediate family member of Dr. Yuan has received personal compensation for serving as an employee of Merck. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Yuan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Yuan has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Salvia. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerenovous. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Regional Anesthesia and Pain Medicine. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Headache and Pain Reports. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cephalalgia. The institution of Dr. Yuan has received research support from NIH. The institution of Dr. Yuan has received research support from American Headache Society. The institution of Dr. Yuan has received research support from Pfizer. Dr. Yuan has received publishing royalties from a publication relating to health care. Dr. Yuan has received publishing royalties from a publication relating to health care. Dr. Yuan has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving as a Invited speaker with Chinese Stroke Association.

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